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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. MISSING
Regular Panel Decision

What Happened in Felix vs. Weber Metals Reconsideration?

This case involves a dispute between Pecker Iron Works and Travelers Indemnity Company of Connecticut concerning the primary versus excess coverage obligations of two liability insurance carriers. Pecker, designated as an 'additional insured' under Upfront Enterprises' policy with Travelers, sought primary coverage after an Upfront worker was injured on a construction site. Travelers contended its policy provided only excess coverage for additional insureds unless explicitly designated as primary in a written contract. The Supreme Court initially agreed with Travelers, but the Appellate Division reversed, holding that coverage for additional insureds is presumed primary unless unambiguously stated otherwise. The Court of Appeals affirmed the Appellate Division's decision, concluding that Pecker was entitled to primary coverage.

Insurance CoverageAdditional InsuredPrimary CoverageExcess CoverageSubcontractor AgreementDeclaratory JudgmentContract InterpretationLiability InsuranceConstruction ProjectAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

Plaintiffs Theodore Howard Dunn, Sr., and Zelma D. Dunn, appealed the trial court's grant of summary judgment to State Farm Mutual Automobile Insurance Company in an uninsured motorist (UM) coverage dispute. Theodore Dunn was injured while driving his employer's (Holiday Inn, Inc.) van, receiving workers' compensation. The Dunns sued the at-fault driver, Ronnie L. Hackett, and served State Farm, their personal UM carrier. The appellate court affirmed the trial court's decision, finding that Holiday Inn, by not rejecting UM coverage in writing as required by T.C.A. § 56-7-1201(a)(2), had primary UM coverage through Old Republic Insurance Company. The court also ruled that an insurance policy's deductible could not apply to uninsured motorist coverage, thereby concluding State Farm's coverage was secondary.

Uninsured Motorist CoverageSummary JudgmentStatutory InterpretationInsurance LawPrimary and Secondary CoverageWorkers' Compensation BenefitsAutomobile Insurance PolicyRejection of CoverageDeductible ApplicationLegislative Intent
References
7
Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

What Did the WCAB Decide in Cuadra vs. Community Home Care?

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. Bronx County Clerk’s Index No. 21460/04
Regular Panel Decision
Apr 06, 2006

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

This case is an appeal concerning a dispute among several insurance companies over the priority of coverage for a construction manager and owner in an underlying wrongful death action. The court analyzed the terms of various primary and umbrella liability policies, establishing that an umbrella policy is generally excess to primary coverage unless specified otherwise within the policy. The Supreme Court's prior ruling on the order of coverage was modified. For Bovis, DASNY, and NYC, the new order of coverage after the exhaustion of QBE's policy is Liberty, then Illinois, followed by United and Westchester sharing ratably. For Stonewall, after QBE's exhaustion, the coverage order is Liberty, then Westchester, with no contribution from United. The court also affirmed that policy provisions, not underlying trade contracts, dictate coverage priority and declined to issue an advisory opinion on Great American's coverage due to prematurity.

Insurance Coverage DisputePriority of CoverageUmbrella Liability PolicyPrimary Insurance PolicyAdditional InsuredSubcontractor InsuranceGeneral Contractor InsuranceConstruction ProjectWrongful Death ActionDeclaratory Judgment
References
24
Case No. MISSING
Regular Panel Decision
May 01, 1981

Can a WCJ Be Disqualified for Appearance of Bias?

This case involves cross-appeals concerning insurance coverage for a State employee, David L. Sinnamon, after an accident. The Attorney-General defended Sinnamon when New Hampshire Merchants Insurance Company, Inc. and Travelers Indemnity Company both refused to provide coverage, despite a prior ruling establishing their respective primary and secondary duties to defend. The State then commenced an action seeking reimbursement for legal fees incurred. Initially, summary judgment was granted against Merchants but dismissed against Travelers due to perceived lack of contractual privity. The appellate court modified this decision, concluding that both insurers breached their independent duty to defend Sinnamon, thus granting summary judgment on liability against both companies and remanding for a damages hearing.

Insurance CoverageDuty to DefendSummary JudgmentCross AppealsReimbursement of Legal FeesPublic Officers LawState Employee DefenseBreach of ContractAppellate ReviewDeclaratory Judgment
References
3
Case No. 5596/2001
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

This declaratory judgment action addresses the priority of insurance coverage for the Herskowitz plaintiffs under policies from Central Mutual Insurance Company and Indian Harbor Insurance Company. The court determined that the Central Mutual policy, issued to Leonard Rosado, provided primary coverage to the Herskowitz plaintiffs as additional insureds, consistent with Pecker Iron Works of N.Y. v Traveler’s Ins. Co. Further analysis of the Indian Harbor policy, which also covered the Herskowitz plaintiffs, led the court to conclude that it too provided primary coverage. As a result, both Central Mutual Insurance Company and Indian Harbor Insurance Company were declared equally responsible for the costs of settling the underlying wrongful death action. The court reserved judgment on the specific method of sharing if not explicitly defined by Central's policy, suggesting a contribution by limits if necessary.

Insurance CoveragePrimary CoverageExcess CoverageAdditional InsuredDeclaratory JudgmentSubcontractor LiabilityGeneral Contractor LiabilityPolicy InterpretationInsurance ContractsOther Insurance Clause
References
14
Case No. MISSING
Regular Panel Decision
Jan 22, 2007

Why Was Removal Denied in Rush vs. California Correctional Institution?

This case concerns an appeal regarding an insurance dispute between Liberty Mutual (excess insurer) and AIG (primary insurer) over a $1.5 million settlement payment in a personal injury action. The underlying action involved an employee of General Industrial Service Corporation, a subcontractor, suing the project's owner and construction manager under the Labor Law. AIG, General's primary insurer, had refused to participate in the defense or settlement. The Supreme Court's order, which limited plaintiff's recovery to $500,000, was modified on appeal. The appellate court increased AIG's potential liability limit to $1,000,000, pending a determination of whether the employee sustained a 'grave injury' under Workers' Compensation Law § 11. The court affirmed that AIG, as a primary insurer, must exhaust its coverage before Liberty's excess coverage is implicated and is not entitled to apportionment with the excess insurer.

Insurance Coverage DisputeExcess InsurancePrimary InsuranceIndemnificationSubrogationWorkers' Compensation LawGrave InjurySummary JudgmentPolicy LimitsApportionment of Liability
References
6
Case No. MISSING
Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

This case involves a supermarket chain (plaintiff) that initially filed a complaint in the Supreme Court of the State of New York, Kings County, seeking an injunction and damages against labor unions (defendants). The plaintiff alleged that the unions were picketing its supermarkets, attempting to discourage customers from buying products from 'Gourmet' (producers of snack products) due to alleged substandard wages, even though the unions did not represent the plaintiff's or Gourmet's employees. The defendants subsequently removed the action to federal court, contending that the complaint implicitly alleged a violation of Section 8(b)(4) of the Labor Management Relations Act, specifically a 'secondary boycott', thereby establishing federal jurisdiction under Section 303 of the Act. The federal court examined whether the complaint described conduct falling within the prohibition of Section 8(b)(4), particularly requiring a primary dispute between an employer and a union. The court concluded that the complaint did not indicate any primary dispute, nor did the consumer product picketing described, even if a primary dispute existed, constitute a prohibited secondary boycott under established Supreme Court precedent. Consequently, the defendants failed to prove federal jurisdiction, and the motion to remand the case back to the State court was granted.

Labor LawSecondary BoycottFederal JurisdictionMotion to RemandLabor Management Relations ActNational Labor Relations ActNorris-LaGuardia ActConsumer PicketingUnfair Labor PracticeState Court Jurisdiction
References
26
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Brentwood Academy sued the Tennessee Secondary School Athletic Association (TSSAA) and its Executive Director, Ronnie Carter, alleging violations of the First and Fourteenth Amendments due to TSSAA's Recruiting Rule. The court found the rule unconstitutional as applied to Brentwood Academy for its 'Spring Practice Letter' and complimentary tickets, ruling it was not narrowly tailored, violated substantive due process due to vagueness and lack of notice, and procedural due process because of the consideration of ex parte evidence during deliberations. Consequently, the court declared the August 23, 1997 penalties imposed by the TSSAA against Brentwood Academy void and enjoined them.

Education LawSports LawFirst AmendmentFourteenth AmendmentDue ProcessFreedom of SpeechRecruiting RuleState ActorUnconstitutional As AppliedInjunctive Relief
References
35
Case No. SRO 139769
Regular
Oct 22, 2007

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

The Workers' Compensation Appeals Board granted reconsideration to address a dispute over the applicant's average weekly earnings (AWE) and temporary disability indemnity (TDI) rate. The original decision calculated the TDI based on total earnings from two jobs, but the defendant argued the primary employer's earnings were miscalculated and the secondary employment should be capped. The Board found the record insufficiently developed regarding the applicant's AWE and returned the case to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardGermain Rodriguez OrtizFull Coverage CompanyState Compensation Insurance FundFindings and AwardIndustrial InjuryRight Ankle and FootTemporary DisabilityAverage Weekly EarningsTemporary Total Disability Rate
References
6
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